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A pilot study to measure the compressive and tensile forces required to use retractable intramuscular safety syringes

      Background

      A pilot study was conducted at the Tampa Veterans Administration Patient Safety Center. The objective was to determine the forces required to operate retractable safety syringes to evaluate potential adverse occupational health and patient safety issues.

      Methods

      Four brands (100 each) of retractable syringes were tested, using a digital force gauge, in air and in a simulated patient material (SPM). Compressive and tensile forces were measured while activating the retraction mechanism and withdrawing saline into the syringe barrel, respectively.

      Results

      The mean compressive force was greater in SPM than in air in all 4 devices. There was a statistically significant compressive force difference between activation in air and SPM in devices 1 and 2 (P ≤ .05). The tensile forces for all devices were lower than the compressive forces. Analysis of variance was used to compare the groups, and the results showed that the means were significantly different (P < .001).

      Conclusion

      This pilot study has implications for device selection, training for users, design issues for manufacturers, and patient safety, as well as potential for future needlestick and ergonomic injuries. We recommend replication of this study with a computer-controlled force testing apparatus, and by testing multiple needle and syringe sizes.
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      References

      1. Panlilio AL, Cardo DM, Campbell S, Srivastaba PU, Jagger H, Orelien JG. Estimate of annual number of percutaneous injuries in U.S. healthcare workers [abstract S-T2-01]. Program and Abstracts of the 4th International Conference on Nosocomial and Healthcare-Associated Infection. Atlanta, March 5-9, 2000:61.

        • Henry K.
        • Campbell S.
        Needlestick/sharps injuries and HIV exposures among health care workers: national estimates based on a survey of US. hospitals.
        Minn Med. 1995; 78: 1765-1768
        • Centers for Disease Control and Prevention(CDC)
        Evaluation of safety devices for preventing percutaneous injuries among health-care workers during phlebotomy procedures: Minneapolis-St. Paul, New York City, and San Francisco, 1993-1995.
        JAMA. 1997; 277: 449-540
        • Haiduven D.J.
        • Simpkins S.M.
        • Phillips E.S.
        • Stevens D.A.
        A survey of percutaneous/ mucocutaneous injury reporting in a public teaching hospital.
        J Hosp Infect. 1999; 41: 151-154
      2. Centers for Disease Control and Prevention, Division of Healthcare Quality Promotion (DHQP), 2004. Sharps injury prevention workbook. Available at: http://www.cdc.gov/sharpssafety/wk_overview.html. Accessed April 21, 2006.

        • Grady G.F.
        Relation of e antigen to infectivity of HBsAg-positive inoculations among medical personnel.
        Lancet. 1976; 1: 492-494
        • Grady G.F.
        • Lee V.A.
        • Prince A.M.
        • Gitnick G.L.
        • Fawaz K.A.
        • Vyas G.N.
        • et al.
        Hepatitis B immune globulin for accidental exposures among medical personnel: final report of a multicenter controlled trial.
        J Infect Dis. 1978; 138: 625-638
        • Werner B.G.
        • Grady G.F.
        Accidental hepatitis B surface antigen-positive inoculations: use of e antigen to estimate infectivity.
        Ann Intern Med. 1982; 97: 367-369
        • Hernandez M.E.
        • Bruguera M.
        • Puyuelo T.
        • Barrera J.M.
        • Sanchez-Tapias J.M.
        • Rodes J.
        Risk of needle-stick injuries in the transmission of hepatitis C in hospital personnel.
        J Hepatol. 1992; 16: 56-58
        • Kiyosawa K.
        • Sodeyama T.
        • Tanaka E.
        • Yoshiyuki N.
        • Furuta S.
        • Nishioka K.
        • et al.
        Hepatitis C in hospital employees with needlestick injuries.
        Ann Intern Med. 1991; 115: 367-369
        • Lanphear B.P.
        • Linneman C.C.
        • Canon C.G.
        • DeRonde M.M.
        • Pendy L.
        • Kerley L.M.
        Hepatitis C infection in healthcare workers: risk of exposure and infection.
        Infect Control Hosp Epidemiol. 1994; 15: 745-750
        • Mitsui T.
        • Iwano K.
        • Masuko K.
        • Yamazaki C.
        • Okamoto H.
        • Tsuda F.
        • et al.
        Hepatitis C virus infection in medical personnel after needlestick accident.
        Hepatology. 1992; 16: 1109-1114
        • Puro V.
        • Petrosillo N.
        • Ippolito G.
        Risk of hepatitis C seroconversion after occupational exposure in healthcare workers. Italian Study Group on Occupational Risk of HIV and Other Bloodborne Infection.
        Am J Infect Control. 1995; 23: 273-277
        • Sodeyama T.
        • Kiyosawa K.
        • Urushihara A.
        • Matsumoto A.
        • Tanaka E.
        • Furuta S.
        • et al.
        Detection of hepatitis C virus markers and hepatitis C virus genomic-RNA after needlestick accidents.
        Arch Intern Med. 1993; 153: 1565-1572
        • Bell D.M.
        Occupational risk of human immunodeficiency virus infection in healthcare workers: an overview.
        Am J Med. 1997; 102: 9-15
      3. House of Representatives 5178, 2000. Needlestick Safety and Prevention Act, 106th Congress, Public Law, 104-130.

        • Ippolito G.
        • Puro V.
        • Petrosillo N.
        • Pugliese G.
        • Wispelwey B.
        • Tereskerz P.M.
        • Bentley M.
        • Jagger J.
        Prevention, management, and chemoprophylaxis of occupational exposure to HIV.
        Advances in Exposure Prevention, International Health Care Worker Safety Center, University of Virginia, Charlottesville, VA1997
      4. International Health Care Worker Safety Center, University of Virginia, 2005. List of safety-engineered sharp devices. Available at: http://www.healthsystem.virginia.edu/internet/epinet/safetydevice.cfm. Accessed April 26, 2006.

        • Nicholas N.C.
        • Welsch J.R.
        Institute for Non-Lethal Defense Technologies (INLDT) report: ballistic gelatin.
        Applied Research Laboratory: Pennsylvania State University, State College, PA2004 (p. 1-20)
      5. Vyse Gelatin Company, Inc., 2003. Ballistic gelatin mixing procedures practiced by the FBI. Available at: http://www.vyse.com/gelatin_for_ballistic_testing.htm. Accessed April 21, 2006.

        • Beer F.P.
        • Johnston R.E.
        • DeWolf J.T.
        Mechanics of materials.
        4th edition. McGraw-Hill, Boston2006 (p. 5)
      6. National Institute for Occupational Safety and Health, 2005. NIOSH facts: work-related musculoskeletal disorders. Available at: http://www.cdc.gov/niosh/muskdsfs.html. Accessed April 21, 2006.

        • Kilborn A.
        Repetitive work of the upper extremity. Part II. The scientific basis for the guide.
        Int J Ind Erg. 1994; 14: 59-86
        • Hoaglund F.T.
        • Byl N.N.
        Musculoskeletal injuries.
        in: LaDou J. Occupational and environmental medicine. Appleton & Lange, Connecticut1997: 54-88
        • Konopack J.
        • DiSalvo H.
        • Applegarth S.
        • Haiduven D.
        From bedside to bench: a pilot study to measure the force required to activate a retractable safety syringe.
        Am J Infect Control. 2005; 33 ([abstract]): e133
        • Prüss-Üstun A.
        • Rapiti E.
        • Hutin Y.
        Estimation of the global burden of disease attributable to contaminated sharps injuries among health-care workers.
        Am J Ind Med. 2005; 48: 482-490
      7. Occupational Safety and Health Administration, 2005. Needlesticks/sharps injuries: example devices with safety features. Available at: http://www.osha.gov/SLTC/etools/hospital/hazards/sharps/sharps.html. Accessed.